| NPI | 1447559984 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 78362)  | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01077062A)  | 
| Enumeration Date | 2011-03-23 | 
| Last Update Date | 2025-03-24 |